There are few stories that cause me to sprint to Facebook and Twitter, but a widely read New York Times opinion editorial by Alice Randall arguing that black women are the most obese group in America because "we want to be" caused me to do just that. Curious to hear what my African-American sister-friends had to say about Randall's claim that we are large because we are seeking acceptance from black men who prefer "sugar down below," I was surprised when the response to my posting was met with... radio silence.
I re-posted the article with an appeal for a debate about a topic that Michelle Obama, the most visible and admired African-American woman on the planet, has been talking about for years -- albeit in the context of the alarming childhood obesity epidemic. The few responses I received highlighted several themes: 1) cultural attitudes against skinny women are present in black popular culture and at home but are not universally shared; 2) psychosocial factors, such as when black women use food as a crutch for depression and loneliness, play a role; 3) environmental factors have a lot to do with it; and, 4) having a cultural preference for curvier bodies does not translate into wanting to be fat.
As the director of a program that focuses on helping policymakers address childhood obesity, I have long been interested in understanding the complex interplay of factors that contribute to the epidemic in communities of color. What has been clear from my work is that a large body of research shows that the environment plays a significant role in shaping the choices that people make.
What do I mean? Just think about being stuck in an airport where your only options include fast food and few opportunities for physical activity. This scenario is a fact of life in many lower-income communities where people of color disproportionately reside.
There is no doubt that where you live can determine how well you live. Neighborhoods where African Americans are concentrated are less likely to have parks, green spaces, swimming pools, recreational facilities and sports clubs. And for those communities that do have access, the evidence suggests that parks and recreational facilities are more likely to be poorly maintained and perceived of as less safe.
I have personal experience with the issue of safety. I used to take regular morning walks in my Washington, DC neighborhood until a woman was murdered in a random robbery attempt while waiting for a bus one block from my house. While I was able to turn to a sports club to continue my exercise routine, this is not an option for many who would find the monthly gym membership fee out of reach. Which brings us to the important connection between poverty and opportunities for healthy living.
This connection is strong on the food side where many African-American communities are oversaturated with fast food restaurants selling cheap foods and beverages that are high in calories and fat but of low nutritional value. Although not good for us, these cheaper options seem reasonable when compared to the economics of accessing and taking the time to prepare healthier but more expensive foods. Studies also show that food and beverage marketers contribute to our poorer health status by targeting the television shows we watch, magazines we read, and events we attend to promote fatty, sugary, carb-heavy foods and drinks.
A lot has been said about the presence of food deserts in lower income communities. Despite recent controversial studies on the matter, the bulk of evidence shows that lower-income communities have less access to supermarkets where residents can purchase affordable fresh fruits and vegetables. The Obama Administration has responded by creating a Healthy Food Financing Initiative to support grocers who want to locate in underserved communities.
On the psychosocial side, a simple Google search yields more than 31 million hits on the connection between obesity and depression. The research not only confirms that there is a strong link between these factors, but it also suggests that depression may be a determining factor for developing obesity. Could it be possible that my Facebook friends are right when they say that African-American women, who are more likely to live in poverty and the least likely to ever be married, are self-medicating their depression by using food as an opiate? I'm not sure. But I do know that new research pointing to the addictive and toxic properties of sugar are likely to provide further clues about the psychosocial and biomedical aspects of this epidemic in black communities.
It is true that cultural factors contribute to the prevalence of obesity among African-American women. Our desire to maintain frizz-free relaxed or hot-combed "straight" hair has long been discussed as a reason why black women tend to avoid sweaty physical activity. But in the face of a large body of scientific research showing the important role that environmental factors play in the obesity epidemic, it irresponsible to suggest that cultural factors are the sole driver of the epidemic among black women.
African-American women must not be reluctant to discuss the issue of obesity if we are to address the health disparities that make us, and the children for whom we are primary caretakers, live sicker and shorter lives. While it is okay to uplift personal behaviors like healthy eating and physical activity as a part of the solution to the problem, we must also address the structural factors that undermine our health. To do so, we must support each other and work in partnership with schools, faith and community groups, businesses, and government leaders to reshape our communities into places where healthier choices are made easier.
Dr. Maya Rockeymoore is President of Global Policy Solutions, a policy consulting firm based in Washington, DC and Director of Leadership for Healthy Communities, a national program of the Robert Wood Johnson Foundation.